Overcoming obesity

Doris Morales has her blood-sugar level and blood pressure checked at a Clinton, N.C., health fair sponsored by the School.

Doris Morales has her blood-sugar level and blood pressure checked at a Clinton, N.C., health fair sponsored by the School.

 The United States – and the world – has a serious weight problem.

More than 65 percent of American adults and a quarter of children are overweight or obese, according to the latest National Health and Nutrition Examination Survey. North Carolina ranks 41st among U.S. states in terms of overweight/obesity. In Mexico, South Africa, Egypt, the United Kingdom and Australia, about two-thirds of all adults are either overweight or obese.

Weight problems during any stage of life increase risk for numerous serious health conditions, including type 2 diabetes, stroke, coronary heart disease, hypertension, gallbladder disease, osteoarthritis, sleep apnea, and breast, colon, and endometrial cancers. People in North Carolina and the U.S. South suffer from high levels of heart disease and diabetes related to obesity.

Obesity is a multi-faceted problem that can be solved only by an integrated, interdisciplinary approach that translates research into meaningful and practical clinical and community solutions. At the University of North Carolina at Chapel Hill, more than 75 faculty members from 23 departments and seven UNC schools are working together to address these problems. These faculty members come from fields as diverse as mass communications, city and regional planning, health behavior, nutrition, epidemiology, health behavior, biostatistics, psychology, medicine, biochemistry and genetics. In every department in the School, faculty conduct obesity-related research. This unique atmosphere at UNC has allowed us to be a global leader in understanding the causes and consequences of obesity.

For example, at UNC, we are:

  • Discovering new information about how fat is metabolized and uncovering links between metabolism and diabetes that could one day lead to reductions in the debilitation common with this disease;
  • Pinpointing the genes that make some animals crave physical activity while others avoid it, and are preparing to do the same in humans;
  • Observing moms and babies to understand the effect of early interactions and feeding styles on the development of obesity;
  • Tracking changing nutrition patterns around the world and assessing reasons for rapid increases in overweight and obesity;
  • Developing and testing practical ways to change environments in child care centers to promote healthier habits in pre-school children;
  • Testing neighborhood programs that support children walking to school;
  • Creating detailed maps of large sections of the country to understand how neighborhood characteristics influence physical activity and dietary habits of the people who live there;
  • Creating and testing Internet programs tailored to individuals of different ages to influence lifestyle and food choices;
  • Coordinating a national study of Hispanic obesity and diabetes;
  • Developing tools to enable pediatricians to assess patients’ BMIs accurately;
  • Launching church-based programs aimed at African-American women and their daughters, tested peer-delivered obesity prevention programs, and developed physical activity programs for middle-school girls in six states;
  • Developing processes for partnering family medicine practitioners with community resources to help patients make healthier choices; and
  • Discovering the particular risks that obese people face during flu epidemics, and the links between diet, exercise, and many cancers, and developing educational messages and campaigns to reduce these risks.

As leaders in moving from discovery to community and policy solutions, our focus is on solutions to real-world problems. We influence local, state, national and global policies and strategies.

For example, Dr. Alice Ammerman’s service on state-level committees and task forces has led to major changes in the state’s response to the epidemic of childhood obesity. Ammerman also has encouraged state leaders who are tackling the transition from tobacco to prioritize the development of healthy, environmentally and economically sustainable local food supplies.

Dr. June Stevens’ membership on national expert panels has resulted in guidelines for obesity prevention and treatment that will be used by practicing physicians around the country for the management of obese patients with cardiovascular disease.

Dr. Barry Popkin’s new book, The World is Fat, has received national and international attention for its clear, dynamic explanation of how changes in America’s food production, eating habits, and activity levels have driven our obesity epidemic – an epidemic that is rapidly spreading across the globe.

Several of our faculty members participated in the development of the American Institute for Cancer Research report Food, Nutrition, Physical Activity and the Prevention of Cancer, which documents the effect of obesity on multiple cancers.

Dr. Anna Maria Siega-Riz served on a recent Institute of Medicine panel that set new guidelines for the amount of weight women should gain during pregnancy.